Ikaros Family Zinc Finger 1 Mutation Is a Poor Prognosis Factor of Adult B Cell Acute Lymphoblastic Leukemia

Objective: To analyze the prognosis of adult B cell acute lymphoblastic leukemia (B-ALL) with Ikaros family zinc finger 1( IKZF1) mutation, and determinethe role of allogeneic hematopoietic stem cell transplantation (allo-HSCT)in improving the clinical outcome.

Methods: IKZF1 mutation was detected at diagnosis in the bone marrow of 164 adult patients with B-ALL using capillary electrophoresis. BCR-ABL fusion gene was also detected by multiple PCR. The clinical data of these patients were retrospectively analyzed.

Results: This study comprised 80 cases with IKZF1 mutation and 84 cases without IKZF1 mutation . Of the 164 cases , 48 cases carried BCR - ABL fusion gene.1.All the patients were divided into transplantation and non-transplantation groups. Univariate and multivariate analyses were conducted to determine the prognosis retrospectively. In the transplantation group, grade III-IV acute-graft-versus-hostdisease (aGVHD) and IKZF1 mutation were independent factors for poor prognosis.In the non-transplantation group, age and IKZF1 mutation were independent factors for poor prognosis. 2.The 3-year overall survival (OS) rate and the 3-year leukemia-free survival (LFS) rate of transplantation group(OS: 59.8 %; LFS: 54.4%) were significantly higher than those of non-transplantation group(OS: 26.7%; LFS21.7%). 3.The 3-year OS and LFS rates of IKZF1+BCR-ABL+ group were lower than those of IKZF1+BCR-ABL- 、 IKZF1-BCR-ABL+ and IKZF1-BCR-ABL- groups in both transplantation group and non-transplantation group.

Conclusion: IKZF1 mutation was an independent factor contributing to poor prognosis of adult B-ALL and worse prognosis in BCR - ABL -positive cases. However, these patients' OS and LFS can be significantly improved by allo-HSCT.